Provider Demographics
NPI:1437780566
Name:BEAUTIFUL SECRETS LLC
Entity Type:Organization
Organization Name:BEAUTIFUL SECRETS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AESTHETICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-688-7255
Mailing Address - Street 1:300 E LANCASTER AVE APT 1101
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2112
Mailing Address - Country:US
Mailing Address - Phone:215-688-7255
Mailing Address - Fax:610-284-0304
Practice Address - Street 1:224 BALA AVE
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2920
Practice Address - Country:US
Practice Address - Phone:484-270-8451
Practice Address - Fax:610-284-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-28
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH1100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHolisticGroup - Multi-Specialty